Question
Could I have been infected with Hep C?
20 December 2012. Related: All topics, Complications and coinfections.
Hello, could you please answer my question regarding transmission of Hepatitis C. I am terrified and extremely worried that I may have contracted Hepatitis C.
I had anal sex (bottom) with a casual partner a week ago who I met online, I am HIV+ with an undetectable Viral Load and the other guy said that he too was Undetectable and on HIV meds.
To cut a long story short the condom completely ripped and tore during anal sex which I asume maybe was caused by friction and lack of lubrication.
When I got home I noticed that there was fresh blood in my underwear and I was in alot of pain in this region. I suffer with hemorrhoids and anal fissure which was aggravated during sex and this lead me to unknowingly bleed and have an open wound. I have never previously experienced bleeding during anal sex. There was also evidence of this casual partners (top) semen inside me when I examined myself, so I know that the condom completely tore open during sex.
I understood from talking with this other person that he had previously contracted Hepatitis C, as he told me that he had managed to clear it with 12 months HCV medication (obviously this is only what I was being told) and am unsure on the person’s actual Hepatitis C status.
Realistically what are my chances of contracting HepC from this unfortunate episode of sex if this person remains HCV+ as I am worried sick.
Thank you.
Answer
Hello,
Thank-you for your email.
I’m very sorry to hear how worried you are. Do you have any support to help you deal with this?
Hep C can be transmitted when there is blood to blood contact. If this partner is HCV+ then there is therefore a possibility of transmission. But if he has cleared the virus then he would no longer be infectious. The information he gave about clearing it after 12 months of treatment is very plausible and it seems strange that he would make this up.
Please try not to worry, but do speak to your doctor about this. It can take up to 3 months for Hep C to show up on antibody tests, but a PCR test (which looks for the virus itself) can detect infection 1-2 weeks after exposure.
If you do test positive you should discuss the pros and cons of treatment with your doctor. 20% of HIV positive people who are infected spontaneously clear the infection in the acute stage. If you have been infected though, and don’t clear Hep C spontaneously, the highest treatment success rates are in early infection.
I wish you the best of luck. Please let us know if you have any questions.
Hi J,
It’s very good that your PCR test has come back negative. Although no test is 100% conclusive this is a very good indication that you don’t have Hep C. Taken together with the fact that your actual risk was low, and that Hep C is actually a difficult virus to catch you have done everything you can to check your status.
As a part of routine monitoring in the UK everybody with HIV should be tested annually for Hep C.
Hi Rebecca
I have spoken to GU Medicine today regarding the PCR blood test that I took on the 14th January and have been told that the lab result is “RNA not detected”.
Does this mean that I am Hepatitis C negative and is this result conclusive, as it wasn’t a Doctor that I spoke to today, and the Health Advisor was unsure if the result was conclusive or not. Do I need to have any further or follow up blood tests following this result?
Many Thanks.
Hi J,
I’m sorry to hear you were disappointed with your GP’s response. Your HIV doctor or GUM clinic should be better able to help with this.
My GP has refused the blood test, passed the buck and told me to go to GUM. She had never heard of a PCR test and quote “knows nothing about hepatitis or HIV”. I am not even going to bother now being tested for HepC. The NHS sucks. There’s ne wonder people do not approach GP’s and the NHS and are diagnosed late with conditions.
Hi J,
Without knowing which part of the UK you live in it is difficult for me to suggest a private clinic. I would suggest waiting to see what your GP says. If s/he is unable to provide the test they may be able to suggest somewhere.
The standard window period for antibody tests is 3 months, because this is the length of time that it can take for antibodies to develop.
Thanks,
I am going to see my GP tomorrow to request a HCV RNA PCR blood test and HCB PCR blood test. If they refuse to perform these due to NHS trust budget, do you know where I can go privately (private GP or private hospital) for these blood tests as I don’t want to wait for the standard 6month antibody blood test that seems standard practice due to NHS budgets.
This study, although very small, suggested that HCV in semen is unlikely to be the risk factor that drive HCV sexual transmission in HIV positive gay men.
http://i-base.info/htb/10544
Hi J,
Unfortunately the mechanism that causes Hep C to be transmitted through anal sex isn’t well understood. You can read more about this in our Hep C guide.
Being diagnosed with a low CD4 count can be very stressful. You may find talking to other HIV positive people helpful. If you let me know where you live I could suggest a local support organisation. You can also call the i-Base phoneline if you want to talk through anything to do with your treatment.
Rebecca
Thank you for your reply. No, unfortunately I do not have any support and am still worrying myself sick as I have a very low CD4 count due to late diagnosis. Could I become infected with Hepatitis C from sperm alone (sperm-blood) as I unknowingly had an open wound, or would this person also have to have a wound for me to contract the virus (ie blood-blood).
Thank you.